Carolina Spine and Pain Centers, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CAROLINA SPINE AND PAIN CENTERS, LLC

Practice address

115 Brushy Creek Rd
Easley, SC 29642-1120

Phone

(864) 635-0376

Fax

(864) 442-6848

NPI assigned

Dec 23, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Blake Leche, MD

Title

Member

Phone

(864) 635-0376

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1467091306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BRUSHY CREEK RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296421120",
            "telephone_number": "864-635-0376",
            "fax_number": "864-442-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 BRUSHY CREEK RD",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296421120",
            "telephone_number": "864-635-0376",
            "fax_number": "864-442-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SPINE AND PAIN CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-23",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "LECHE",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "864-635-0376",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314305",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Capstone Rehabilitation and Healthcare Center, LLC
• Caring Hearts
• Joshua B Carlson, RPH
• Carolina Center for Postural Orthostatic Tachycardia Syndrome and Other Dysautonomias
• Carolina Pulmonary & Sleep Disorder, LLC
• Carolina Spine Pain LLC
• Cassidy Lee Caron, CSFA
• John Michael Carpenter, CRNA
• Virginia Neely Todd Carraway, DMD
• Anita Carter

• Multi-Specialty Clinic/Center in Easley, SC
• Providers in Easley, SC by specialty
• Multi-Specialty Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.